FDG PET Detection of Neurolymphomatosis in Diffuse Large B-cell Lymphoma, With Neuropathy as Presenting Complaint

Two patients with neurolymphomatosis as the initial manifestation of diffuse large B-cell lymphoma are presented. Both patients experienced mixed severe sensorimotor neuropathy as their presenting complaint. Subsequently, both had a prolonged interval to diagnosis, 6 and 14 months, respectively. MRI or CT imaging in both cases was nondiagnostic, and FDG PET/CT was used to demonstrate intense uptake throughout spinal nerves, leading to biopsy and definitive diagnosis. FDG PET/CT is a valuable investigation that should be considered early in cases of intractable progressive neuropathy to eliminate malignant differential causes.